Home Office

Immigration

Lord Rosser: To ask His Majesty's Government how many Home Office immigration decisions were made in (1) 2017/18, (2) 2018/19, (3) 2019/20, (4) 2020/21, and (5) 2021/22; and how manysuch decisions were overturned on appeal in each of those years.

Lord Murray of Blidworth: The Home Office publishes a range of data related to immigration in the Immigration Statistics Quarterly Release. Attached is the most recent publication of data for asylum and resettlement.Data on appeal outcomes is published by HM Courts and Tribunals Service.Asylum summary - Sept 2022 (xlsx, 110.0KB)

Mike Veale

Lord Lexden: To ask His Majesty's Government what discussions they have had with the Independent Office for Police Conduct about the timing for the publication of the report on Mr Mike Veale, which was completed in February 2021; and whether they received any indication on when it will be published.

Lord Sharpe of Epsom: The Independent Office for Police Conduct (IOPC) is independent of government and publication of investigation reports is a matter for the IOPC in accordance with its policy on the subject,

Trespass

Lord Haworth: To ask His Majesty's Government how many protected sites had been designated under section 128 of the Serious and Organised Crime and Police Act 2005 as of 1 June.

Lord Sharpe of Epsom: As of 1 June 2022, there are 60 protected sites designated under section 128 of the Serious and Organised Crime and Police Act 2005. A list of these sites are publicly available on gov.uk.

British National (Overseas): Visas

Lord Leong: To ask His Majesty's Government how manyBritish National (Overseas) visas have been issued since the visa scheme was launched; and how many of those have settled in the UK.

Lord Murray of Blidworth: The Home Office releases data on the BN(O) route as part of the quarterly migration statistics. There were a total of 121,193 BN(O) route applications made out of country granted between 31 January 2021 and 30 September 2022, and a total of 23,383 BN(O) route applications made in country granted between 31 January 2021 and 30 September 2022.14 people on the BN(O) visa route have been granted settlement in the UK up to the end of September 2022The Home Office publishes data on visas, grants of settlement and the British National Overseas (BN(O)) route in the ‘Immigration Statistics Quarterly Release’ on GOV.UK.Data on the number of entry clearance visa grants to main applicants under the BN(O) route are published in table Vis_D02 of the entry clearance visas applications and outcomes detailed dataset. Data on the number of grants of settlement are published in table Se_D02 of the settlement detailed datasetInformation on how to use the dataset can be found in the ‘Notes’ page of the workbook. The latest data relates up to, and including, September 2022. Information on future Home Office statistical release dates can be found in the ‘Research and statistics calendar’.

Department for Education

Special Educational Needs

The Marquess of Lothian: To ask His Majesty's Government what is the average waiting time between requesting an assessment and an Education, Health and Care Plan being issued; which local authorities have the longest assessment, planning and review processing times for these plans; and what plans they have, if any, to change statutory timelines for the delivery of these plans.

Baroness Barran: The Special Education Needs and Disability (SEND) Regulations 2014 set out that the local authority must, unless certain specified exemptions apply, finalise the education, health and care (EHC) plan within 20 weeks of the local authority receiving a request for an assessment. 62,200 new EHC plans were issued during 2021, an increase of 3% compared to the previous year, and 59.9% of the EHC plans were issued within the statutory 20 weeks.The department does not collect data on the average waiting times for EHC plans, but instead collect and publish data on the number and percentage of EHC plans issued within 20 weeks at the local authority level, both including and excluding exceptions. From this data, the department cannot establish which local authorities have the longest average waiting times.In March 2022, we published the Special Educational Needs and Disabilities (SEND) and Alternative Provision (AP) Green Paper, which sets out our proposals to ensure that every child and young person has their needs identified quickly and their needs met consistently. The department proposes to improve families’ experiences of the EHC plan process by introducing standardised and digitised EHC plans. The department is committed to publishing a full response to the SEND and AP Green Paper in an improvement plan early in 2023.The department will continue to support the system in the immediate term to continue to improve the experience and outcomes for children and young people with SEND and those who need AP.

Ministry of Defence

F-35 Aircraft: Early Warning Systems

Lord West of Spithead: To ask His Majesty's Government, further to the Written Answer byBaroness Goldie on 12 December (HL3834), what is the definition ofFull Operational Capability of Carrier Strike.

Baroness Goldie: The Full Operating Capability (FOC) of the Carrier Strike is defined as a Queen Elizabeth Class carrier able to operate with 24 F35B Lightning and supporting ships and helicopters. This increases to 36 F35B and four Crowsnest Airborne Early Warning helicopters when the Queen Elizabeth Class carriers are operating within a Maritime Task Group configuration. These will continue to be the defining features of any future FOC declaration.

Military Bases: Omagh

Lord Empey: To ask His Majesty's Government what expenditure wasincurred between 2007 and 2021 on (1) security, and (2) maintenance, at St Lucia Barracks in Omagh, County Tyrone.

Baroness Goldie: The cost of security provision for St Lucia Barracks prior to 2015 is not held by the Ministry of Defence (MOD); security costs were managed by the Department for Education.The cost of security provision incurred by the MOD for St Lucia Barracks for the period Financial Year (FY) 2015-16 to FY 2020-21 was £442,331. This is 60% of total costs; the remaining 40% is met by the Northern Ireland Department for Infrastructure.Information on maintenance expenditure for St Lucia Barracks from FY 2006-07 to 2009-10 is not held.Maintenance expenditure for St Lucia Barracks from FY 2010-11 to FY 2020-21 was £570,100.

Department of Health and Social Care

Hypothyroidism: Prescriptions

Lord Hunt of Kings Heath: To ask His Majesty's Government what plans they have to direct NHS England to ensure that when patients are (1) currently prescribed, and (2) previously prescribed, Armour Thyroid medicine for the treatment of hypothyroidism, their GP should be permitted to continue to prescribe the medicine.

Lord Markham: Prescribers must ensure that the medicines considered appropriate for their patients can be safely prescribed and take account of the appropriate national guidance on clinical effectiveness and the local commissioning decisions of their respective integrated care boards.The National Institute for Health and Care and Excellence recommends that natural thyroid or armour thyroid extract should not be offered for the management of primary hypothyroidism due to insufficient evidence that it offers greater benefits than levothyroxine.

Cancer: Radiotherapy

Baroness Ritchie of Downpatrick: To ask His Majesty's Government whatplans they have to improve access to radiotherapy treatments for cancer patients.

Lord Markham: Since 2016, over £160 million has been invested in radiotherapy equipment, which has replaced or upgraded approximately 100 radiotherapy treatment machines. In 2019/20, 11 radiotherapy networks were established in England to increase access to specialist skills and improve patient outcomes.In 2022/23, NHS England will complete a capacity and demand review of external beam radiotherapy capacity. This will support local systems to plan radiotherapy provision and allocate system capital allocations appropriately, based on an assessment of equipment age, capacity and demand, opportunities to improve access and service risk.

Prescription Drugs: Shortages

The Marquess of Lothian: To ask His Majesty's Government what steps they are taking to resolve current supply issues limiting the availability of many prescription medicines, including antibiotics for the treatment of Group A Streptococcus; and how many prescription medicines in England currently have longer than average fulfilment times.

Lord Markham: We are continuing to work with manufacturers and wholesalers to accelerate deliveries to address temporary issues with the supply of antibiotics used to treat Group A Streptococcus and meet current demand.We have introduced eight Serious Shortage Protocols in the United Kingdom for penicillin medicines to mitigate and support fulfilment times and local supply issues. This allows pharmacists to supply alternative forms of the medicine or alternative antibiotics, if the product stated on the prescription is unavailable. Data on fulfilment times for prescription only medicines is not held centrally.

Cancer: Health Services

Baroness Ritchie of Downpatrick: To ask His Majesty's Government what plansthey have to increase cancer treatment capacity in line with current demand.

Lord Markham: The National Health Service will recover and expand elective services over the next three years, including cancer services. This includes reducing the number of people waiting more than 62 days to commence treatment following suspected cancer to pre-pandemic levels by March 2023. We have allocated more than £8 billion from 2022/23 to 2024/25, in addition to the £2 billion Elective Recovery Fund and £700 million Targeted Investment Fund already made available in 2021/2022 to increase elective activity, including cancer services.

Health: Disadvantaged

Baroness Merron: To ask His Majesty's Government what steps they are taking to track and reduce health inequalities in highly specialised NHS services.

Lord Markham: All annual clinical meetings for highly specialised services review health inequalities. NHS England provides advice on how the arrangement of highly specialised services should consider health inequalities, with a focus on access, experience and outcomes. NHS England is developing a framework and resources on how health inequalities can be identified and addressed in the commissioning of highly specialised services, which will be piloted in several services.NHS England is also collating information on how procurements of healthcare services have addressed healthcare inequalities to provide lessons learned and best practice. An equalities health impact assessment is used when procuring highly specialised services and guidance is available to commissioners on how this assessment should be completed.

Antimicrobials: Drug Resistance

Baroness Finlay of Llandaff: To ask His Majesty's Government what steps they are taking to maintain the UK’s international leadership on tackling antimicrobial resistance by building on the momentum generated bythe UK’s G7 presidency in 2021.

Lord Markham: We continue to work with G7 partners to implement commitments made on antimicrobial resistance (AMR), including those secured during the United Kingdom’s 2021 presidency. The UK Special Envoy on AMR, Professor Dame Sally Davies, also recently attended the Third High-level Ministerial Conference on AMR in Oman. In November 2022, the Government issued a call for evidence to seek expert contributions to the next five-year AMR national action plan, which has been shared with international counterparts.

Brain Cancer: Health Services

Lord Hunt of Kings Heath: To ask His Majesty's Government what steps they are taking to improve after care for patients who have received surgery for the treatment of brain tumours.

Lord Markham: Where appropriate, every person diagnosed with cancer will have access to personalised care, including needs assessment, a care plan and health and wellbeing information and support. This is being delivered through the National Health Service comprehensive model of personalised care, empowering patients to manage their care and and maximise the potential of digital and community-based support. All patients will have access to the appropriate expertise and support, including a Clinical Nurse Specialist or other support worker. After treatment, patients move to a follow-up pathway to suit their needs, which ensures rapid access to clinical support is available should they have concerns regarding their health.NHS England is reviewing and updating all service specifications, which describe the relevant specialists involved in clinical multidisciplinary teams to optimise patient care.

NHS: Drugs

Baroness Merron: To ask His Majesty's Government what assessment they have made of the standards set by the Royal Pharmaceutical Society’s Professional Standards for Homecare Services in England, published in September 2013, whichare embedded into all framework agreement service specifications for providers of homecare medicines services; and in particular, what assessment they have made whether those standards are sufficient regarding (1) delayed deliveries, (2) delayed treatment initiation, and (3) missed doses.

Lord Markham: No recent assessment has been made. However, in 2014 the Royal Pharmaceutical Society published the Handbook for Homecare Services in England to aid implementation of the 2013 standards. This identified examples of good practice which may be used by homecare teams to develop robust arrangements for compliance with those standards. A copy of Handbook for Homecare Services in England is attached.The National Homecare Medicines Committee holds regular meetings with all homecare providers focused on Key Performance Indicators (KPIs) for standards based on those contained in Appendix 10 National KPI definitions of the Handbook for Homecare Services in England. These definitions include the monitoring of delayed deliveries, treatment initiation and missed doses. A copy of Appendix 10 National KPI definitions is attached.In addition, NHS England’s Commercial Medicines Unit hold regular review meetings with contracted homecare providers every three months. Homecare providers are assessed on a monthly basis against the same KPIs. Where these KPIs not met, suppliers are held to account through stakeholder meetings, reporting metrics and face to face meetings to ensure that levels of service are aligned with the relevant professional standards.The National Homecare Medicines Committee also enacts an escalation process where the relevant homecare provider is required to communicate a summary of the issues, mitigations and expected timescales for recovery to the National Health Service organisations involved. If necessary, the Care Quality Commission and the General Pharmaceutical Council are also informed.Appendix 10 National KPI definitions (xlsx, 349.9KB)Handbook for Homecare Services in England (pdf, 576.4KB)

Malnutrition: Screening

The Lord Bishop of St Albans: To ask His Majesty's Government why screening of malnutrition is not standard practice in all health settings across England.

Lord Markham: The National Institute for Health and Care Excellence recommends that all hospital inpatients on admission and all outpatients at their first clinic appointment should be screened for malnutrition. Screening should be repeated weekly for inpatients and when there is clinical concern for outpatients. Residents in care homes should be screened on admission and when there is clinical concern.

Hypothyroidism: Prescriptions

Lord Hunt of Kings Heath: To ask His Majesty's Government what alternative medicine will be made available to patients for the treatment of hypothyroidism in the event that (1) Liothyronine (T3), and (2) Levothyroxine (T4), medications prove to be ineffective.

Lord Markham: In the event of a medicine proving ineffective, a general practitioner or other responsible clinician should work with the patient to determine the most appropriate course of action or further treatment. Prescribers should ensure that the medicines considered appropriate for the patients can be safely prescribed and take account of appropriate national guidance on clinical effectiveness and the local commissioning decisions of the local integrated care board. Arrangements for monitoring the effects of the medicines should be agreed with the patient on prescribing.

NHS: Finance

Lord Warner: To ask His Majesty's Government what steps they have taken to identify the range of costs among NHS acute hospital providers for (1) routine (a) hip, (b) knee, and (c) cataract, operations, (2) routine (a) CT, (b) MRI scans, and (c) x-rays, and (3) routine pathology tests; and whether they will publish such information as an aid to holding NHS providers to account for public expenditure.

Lord Markham: NHS England collects and publishes ‘National Cost Collection for the NHS’ annually in an online only format. This data is collected by Healthcare Resource Groups (HRGs), which are standard groupings of clinically similar treatments using similar levels of healthcare resources. This data will show HRGs for hip, knee, cataract procedures and outpatient computerised tomography (CT) or magnetic resonance imaging (MRI) when the relevant clinical coding has been documented in the patient’s record. A cost for the activity will then be assigned by the relevant National Health Service trust. However, where a CT or MRI has been undertaken during an inpatient episode or attendance in accident and emergency, this will be included in the composite cost of the HRG and will not be separately identifiable. While information on x-rays and pathology testing is collected, this is for direct access for general practitioners (GPs). The report of an x-ray or result of a pathology test is returned to the GP rather than a hospital clinician or consultant. Where this procedure is undertaken at the request of a hospital clinician or consultant, it is not reported separately. Additionally, data on costs is also made available to NHS providers through Patient Level Information Costing System (PLICS) dashboards, the Model Hospital and Getting It Right First Time programmes, which support health providers to improve patient treatment and productivity. The PLICS dashboards allow trusts to examine data to understand the difference between costs incurred in comparison to other similar organisations. NHS England uses this information and other performance data to hold NHS organisations to account.

Aircraft: Air Conditioning

Baroness Bennett of Manor Castle: To ask His Majesty's Government what assessment they have made of exposure to engine oil and hydraulic fluid among airline crews; and what plans they have to fund research into the issue of exposure, which can lead to the condition Organophosphorus Ester-Induced Chronic Neurotoxicity.

Lord Markham: In 2013, The UK Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) reviewed four research projects on airborne concentrations and surface deposition of chemical pollutants in the cabins of commercial aircraft, which had been commissioned by the Department for Transport. The COT concluded that contamination of cabin air by components and/or combustion products of engine oils, including triaryl phosphates, does occur and peaks of higher exposure have been recorded during episodes that lasted for seconds. No further assessments have been commissioned.The Department funds research through the National Institute for Health and Care Research (NIHR). The NIHR welcomes funding applications for research into any aspect of human health, including research into environmental exposure. However, it is not usual practice to ring-fence funds for particular topics or conditions. Applications for funding are subject to peer review and judged in open competition, with awards made on the basis of the importance of the topic to patients and health and care services, value for money and scientific quality.

Aviation: Pregnancy

Baroness Bennett of Manor Castle: To ask His Majesty's Government what assessment they have made of whether exposure to synthetic jet engine oil and hydraulic fluids or their decomposition products poses any risk to unborn children.

Lord Markham: The Department for Transport has asked the UK Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) to update its 2007 and 2013 reviews and statements on the potential human health effects due to fume and contamination events. This review is continuing and a statement will be published in due course. However, effects on an unborn child are not being specifically assessed.

NHS: Private Sector

Lord Warner: To ask His Majesty's Government what, if any, central contracts have been let by NHS England with independent care providers to increase NHS (1) diagnostic, and (2) elective surgery, capacity; and what guidance has been given by NHS England to local commissioners to use independent service providers in order to reduce the backlog of NHS patients awaiting (a) diagnosis, and (b) treatment.

Lord Markham: The majority of commissioning between independent sector providers and the National Health Service takes place locally. While central contracts were regularly used by NHS England during the pandemic, in 2022/23 there have been no central contracts between NHS England and independent care providers to increase diagnostic or elective surgery capacity. In February 2022, NHS England published the Delivery plan for tackling the COVID-19 backlog of elective care, which sets out how the National Health Service will recover and expand elective services over the next three years. It advises that effective use of the independent sector should be encouraged to increase capacity and reduce waiting times. A copy of the plan is attached. In January 2022, NHS England published the 2022/23 priorities and operational planning guidance, which states that independent sector should be considered to manage winter pressures and increase capacity, including through virtual wards. A copy of the guidance is attached.2022-23 Operational Planning Guidance (pdf, 323.4KB)Elective Care Backlog Delivery Plan (pdf, 610.7KB)